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The Radical Nature of Body Acceptance

The Radical Nature of Body Acceptance

by | Sep 11, 2024

I commute to work on the I-15 highway for several miles. Today, I saw a billboard advertisement for $250 a month Semaglutide weight loss shots, another billboard for the “skinny shot” (assuming another Wegovy/Semaglutide advertisement), another billboard for Cool Sculpting, and another billboard for transforming the “dad bod” with a 10-foot photo of a “real client.” 

In one of my therapy sessions, my client led the session saying, “Anna, look at the number of weight loss ads I got on my social media feed, in just one session of scrolling!” She proceeded to show me screen shots of over half a dozen weight loss ads from her IG feed.

The world has not gotten any less pervasive in its dissemination of weight loss advertisements and products, continually prompting us to be dissatisfied with our bodies and believe that weighing less, being less, is the solution. 

Last week in my Eating Recovery group, group members talked about the difficulty of finding body acceptance. They shared how trite it feels to be grateful or difficult it feels to be neutral about their bodies in a world that denies body neutrality as an option. 

Besides fighting the tides propelling body change, body acceptance can also come with some costs. For example, it can be lonely as you no longer participate in body-hate-bonding or diet-talk. You may feel disconnected from valued social communities that bonded over weight loss pursuits and activities. You may not know what to do with all your emotional and physical freedom once you liberate yourself from the exhausting pursuits that weight loss constantly requires. I have heard many times, “But what goals will I have, if I’m not always trying to lose weight?”

For all these reasons and more, I always talk about how body acceptance is a radical act. You are betraying societal norms when you reject the societal formula to chronically pursue body change. If you want to join a community of fellow body-acceptance-travelers as you forge this brave path, consider joining the next round of my 12-week Body Acceptance Group starting this fall! In this space, we will help support your personal efforts to become more liberated, empowered, and embodied. 

Click here to join us this fall!

Psychologist’s Take on ‘Magic Pill’ by Johann Hari

Psychologist’s Take on ‘Magic Pill’ by Johann Hari

by | Aug 14, 2024

Those of us in the world of treating eating disorders and body image concerns have been following the Ozempic craze for a couple of years now. Today, everyone knows about Ozempic given its proliferation in our society. Ozempic is literally the zeitgeist of our times. In May of this year, CNN reported that 1 in 8 US adults have been on a GLP-1 drug (like Ozempic and Wegovy) and more than 15 million US citizens are actively using this prescription. Beyond this, 25,000 people are getting a new prescription for these Wegovy each week in the United States. We all know people, or know of people, who are taking these drugs. The impact of this drug has been compared to the inception of the iPhone and birth control pills. These drugs have the reputation of being the long hoped for “miracle pill” to “cure the obesity epidemic.” 

As you can imagine, I have many concerns, feelings and opinions about these drugs. That said, I am also trying to understand all sides of this controversy. In this effort, I recently read the newly published book, “Magic Pill: The extraordinary benefits and disturbing risks of the new weight-loss drugs” by Johann Hari. 

First, I’ll talk about what I liked about this book. I appreciated how well Hari covered these weight loss drugs, including the societal narratives, structures, and factors that shape our understanding of these issues. He also documented the limitations of our knowledge about how these drugs work and how they will impact people individually and societtaly as a whole. Hari did a comprehensive job of documenting the “pros,” “cons,” and “risks” associated with these drugs. “If you want a book uncritically championing these drugs, or alternatively a book damning them, I am afraid I can’t give it to you.” Hari identifies and shares research about the known medical and psychological risks associated with these drugs. They are not minor concerns and initiating these drugs should be carefully considered and explored with one’s (competent and knowledgeable) doctor before initiating treatment.

My favorite part of the book came from Hari’s honest self-confrontation around his own ambivalence about these drugs and his incentives to take them himself. Hari shares a painful and direct conversation he had with a good friend, who confronts him about his body image concerns. She accuses him of hiding behind “health concerns” to justify his use of Wegovy, when in reality, his main incentive to lose weight is his vanity. Hari admits this to be true and engages in meaningful exploration of how weight stigma and body image distress affect mental health and societal values. While many people may take these drugs for health reasons, it is undeniable that these drugs continue to foster and fan the flames of the toxic thin ideal. 

At the heart of “Magic Pill” is a critique of the quick-fix mentality prevalent in our approach to health and wellness. Hari argues that while medications like Ozempic may offer immediate results, they often mask underlying societal and relational factors contributing to mental and physical health issues. He emphasizes that the use of such drugs, particularly in the context of weight loss, raises critical ethical questions about our values, the pressure to conform to societal beauty standards, and the pharmaceutical industry’s role in shaping these narratives.

Now for what I didn’t like. I did not like Hari’s villainization of the food industry. I would never recommend this book to a client with an eating disorder as the content he shares about how our food is made and processed would be very triggering. He was overly reductionistic in his conclusions about the food industry. While I do not deny that there are problems inherent in our food industry and there are solutions to these problems that should be explored, I also know of the pathology and paradoxical unhealthy relationship we create with food through villainizing it.

Similarly to how Hari talks about the food industry, I found his conclusions from the research to be overly reductionistic, often based on conversations with select experts. I understand this book isn’t designed to comprehensively cover all the complexities of this topic, and I felt like some conclusions were premature and lacking in nuance. 

Finally, I feel Hari missed an important hazard of these drugs. He talked about the concerns for people with eating disorders accessing these drugs to facilitate their restriction and weight loss. I absolutely agree and even, anecdotally, already know of doctors giving these drugs to people with known, active eating disorders. This is incredibly problematic and dangerous. But what Hari didn’t explore (perhaps because he doesn’t know enough to predict this) is the likelihood of these drugs creating eating disorders in people who previously have not struggled in this way. These drugs are designed to disrupt intuitive body cues and one’s relationship with food. It is not totally understood how these drugs work, but they affect physical hunger/satiety, as well as desire for food, and decrease reinforcement for consuming food. These drugs are no different from other diets, and ceasing these drugs leads to rebound weight gain. What happens for these individuals who experience distress as their body regains weight, but have lost their intuitive connection with their bodies and food? This is the perfect recipe for the onset of an eating disorder. I hope I’m wrong, but strongly suspect these drugs will correlate with an even sharper rise in eating disorders, beyond the continuous escalation of prevalence we see now. 

 

Overall, I am glad I read this book and recommend it. It provided a good exploration of the complex and controversial issues surrounding these weight loss drugs. It provides insight into the risks of taking these medications, as well as understanding and compassion for why people feel compelled to seek weight loss drugs in the first place. While Hari takes these drugs himself, and does lean more towards these drugs being a “pro” than a “con,” he also says several times that these drugs treat symptoms and not the underlying concerns that afflict our society and our relationship with food and our bodies. These drugs offer a “quick fix” without pursuing progress toward addressing these underlying concerns. 

 

Link To Article

Link to Book

 

Tips For an “Awe-some” Summer

Tips For an “Awe-some” Summer

by | Jun 26, 2024

I am a summer lover. I try to convince myself I love all seasons but summer is the most intuitive season for me to love. Summer calls me outside, and Mother Earth invites me to play. There isn’t much that makes me happier than exploring and hiking the Wasatch Wilderness at the height of summer. It is in the mountains that I most commonly experience a sense of awe. Awe is one of my favorite emotions to feel. Awe is one of those emotions that can be hard to describe, but we know it when we feel it. It can feel like a sense of wonder, inspiration, transcendence, presence, complete absorption in the present experience, humility in the awareness of something magnificent, or something that invites us beyond our normal lived experience and into something more sublime. 

Awe can be experienced in a variety of contexts, from witnessing great acts of kindness, natural phenomena, artistic masterpieces, music, spiritual practices, meditation, communal gatherings, and celebrations, to name a few.  The summertime, with its longer days and inviting weather, offers a perfect canvas for cultivating these awe-inspiring experiences. 

Awe is more than just a fleeting feeling of amazement. It has significant psychological and physiological benefits. Awe is known to increase feelings of happiness and well-being, reduce stress and anxiety, increase a sense of connection with others, boost creativity, and increase gratitude, and mindfulness. 

While awe is a feeling, we can cultivate experiences that invite awe and also attune ourselves to it so that it becomes a more common experience for us. Dacher Keltner is a researcher on awe and the author of the new book: Awe: The New Science of Everyday Wonder and How It Can Transform Your Life. He describes that people who frequently experience awe have traits of open-mindedness and the ability to be absorbed or get lost in experiences. We can cultivate these traits through practicing curiosity and mindfulness. We can look for and be open to moments of awe. Indeed, we can find awe in everyday moments if we look for them. 

I love these simple life instructions from the poet Mary Oliver:

Instructions For Living a Life:

Pay attention.

Be astonished.

Tell about it.

Awe is a powerful emotion that can enrich our lives in myriad ways. By intentionally seeking out awe-inspiring experiences, especially during the summertime, we can cultivate a deeper appreciation for the world around us, feel connected to ourselves and others, and enhance our overall well-being. Whether through nature, culture, travel, mindfulness, or adventure, opportunities for awe are abundant and waiting to be discovered. Embrace the summer and let the world amaze you.

Here are some ways to create these moments:

Explore nature (my personal favorite) Nature is one of the most consistent sources of awe. Whether it’s a majestic mountain range, a serene forest, or the vast ocean, natural landscapes have a way of making us feel small in the best way.

  • Hiking: Find a local trail and spend an hour to a day hiking. The options are endless if you live in Utah, and the terrain varies from mountain peaks to valleys full of wildflowers and rushing waterfalls. 
  • Star gazing: Stargazing in a remote area, away from city lights, can be a humbling and awe-inspiring experience.
  • Water Activities: Kayaking, paddleboarding, or even just a swim in a natural body of water can provide a refreshing and awe-inducing connection with nature.

Attend Cultural Events: Summer is often filled with festivals, concerts, and outdoor performances that can evoke a sense of wonder and connection with others. For example, this September, I hope to make it to the Night Lights Lantern Festival, where I can have my own real life Disney’s Tangled moment. Other ideas include:

  • Music festivals: The collective energy of a live music performance, especially in an open-air setting, can be profoundly moving. Deer Valley in Park City always hosts a summer music festival, and several venues all around Utah host outdoor summer concerts. 
  • Art Installations: Visit outdoor art exhibits or public installations that invite interaction and contemplation. This can even include events as simple and local as Farmer’s Markets, where artists often show and sell their wares.

Travel and Discover: Traveling to new places, whether near or far, can offer fresh perspectives and novel experiences. This doesn’t have to be expensive or grandiose. Plan a road trip to explore unfamiliar destinations. The journey itself, with its changing landscapes and spontaneous discoveries, can be awe-inspiring. Utah has many potentially awe inspiring locations easily accessed by car. For example, I hope to visit the salt flats for a sunset sometime soon and finally see the spiral jetty in the Great Salt Lake. We are so close to several National Parks as well!

Mindful Practices. Good grief…I wonder when I will ever be consistent in my meditation practice. It’s something that is so hard for me to do…even though I know it’s very good for me. Meditation feels more doable and inviting when I do it outdoors. But meditation is also just one form of mindfulness. Practicing mindfulness…paying attention to the present moment, invites that curiosity and openness for awe in the everyday moments.

Document moments of awe. 

  • Photography: I love capturing moments of beauty and wonder on camera. This practice encourages me to look at the world with fresh eyes and find awe in the details. And I can remember and relive the sense of awe I felt when I reflect on the photos I captured.
  • Journal: For me, this can be how I “tell about it” from Mary Oliver’s life instructions. Reflecting on the context of moments of awe, how I felt, and what the experience meant to me can amplify its importance and translate the experience into more meaning for me. 

What other ideas do you have? 

A New Way to Think About Body Acceptance

A New Way to Think About Body Acceptance

by | May 15, 2024

I am passionate about body acceptance work. I teach it, practice it, and continue to learn and evolve my understanding of how to do this work. The body acceptance journey is often described using the metaphor of a ladder. In fact, when I lecture about body acceptance, I use the following image to capture the idea: 

However, when we used this image in our Body Acceptance Group this last month, my understanding of this “progressive approach” was turned on its head. So many clients share about how they can be in a more accepting or healthy place with their body one day and, the next, feel right back at “ground zero.” Others describe how they can inhabit multiple places with their body at once. For example, they can feel grateful for their body while also feeling disgust for how it looks. They can feel compassion for what their body has gone through and also resent that it refuses to change the way they want it to change. It suddenly became clear in this discussion that the ladder doesn’t fit these experiences at all. I know body acceptance is a non-linear journey, but when we talk about progress, we talk about being in different places than we were before. It’s as if we keep arriving or stepping up to somewhere new, and different, and stable. The journey is so much more fluid and complicated than that. In this group, I suddenly envisioned a better way to conceptualize the body acceptance journey. And it’s one of bubbles. 

Our experiences and relationships with our bodies are deeply rich, historical, personal, complicated, and nuanced. In a holistic perspective, we always carry with us each of these lived feelings, perceptions, beliefs, and behaviors in our bodies. Sometimes certain bubbles expand and take up a lot of room. For example, an event or interaction in our lives may trigger more negative feelings about our bodies. Or maybe we are feeling more vulnerable in general and are more prone to feel amplified negative emotions about our bodies. 

Through body acceptance work, there is active movement to amplify and grow different ways of being with our bodies. There is choice in what works for you and what you value, and this journey involves a lot of trial and error and hard work. For some people they really resonate with amplifying body gratitude and find a lot of joy and relief in this. For others, maybe they want to focus even less on their bodies and so focus on identifying and living more intentionally, their values (valued living) and feel a lot of relief in doing so. Some enjoy experimenting, growing skills, and amplifying many different ways of being with their bodies and find at different times, different tools and orientation work better than others. In this work, you will notice these other experiences you are intentionally amplifying will take up more space in your lived reality with your body. And while this doesn’t make more painful experiences or beliefs disappear completely, it changes the overall experience with yourself. 

This lived experience in your body is a moving, changing, fluid experience. As we work, we build confidence and more stability in inviting and amplifying the experiences, feelings, and beliefs we want to have in our bodies. But this doesn’t mean hard days disappear where other feelings and experiences rear their heads and dominate the day. 

There is no “falling backwards” or “getting worse” with this framework of body acceptance. It is simply awareness that certain bubbles are larger today, or this week, and this affects how we feel. We can make conscious choices to use the tools and knowledge we have to attend to the bubbles we want to grow and amplify and have compassion for ourselves on days we are simply doing our best to get by. The body acceptance journey, just like mediation, is a practice, not a final destination. Over time it is easier and more and more rewarding, and it continues to invite us to work and be with ourselves in intentional ways as we move through this messy experience that is life. 

What does ADHD have to do with Eating Concerns? Part 2

What does ADHD have to do with Eating Concerns? Part 2

by | Mar 13, 2024

The more we learn about ADHD and eating disorders, the more we are coming to understand that the incidence of ADHD is actually higher in the eating disorder population and is not just eating disorders “looking like” ADHD. Something is happening here that warrants further understanding and exploration of how we approach eating disorder treatment when this comorbidity is present. 

There are biological, cognitive, and behavioral patterns inherent in both that can influence the severity and longevity of the eating disorder, as well as the recovery trajectory. People with ADHD and eating disorders have differences in how their brains process rewards, often looking for dopamine hits that can come from eating disorder behaviors. Disturbance in body awareness as an associated feature interferes with the ability to feel hunger/satiety cues and feelings. Difficulties with decision-making, planning, as well as time-blindness and difficulty with transitions, make it harder to meal plan and nourish oneself consistently throughout the day. People with ADHD often seek certain types of food making it more difficult to eat a wide variety of food. These are just some of the many nuances that show up with clients who have both an eating disorder and ADHD. 

The treatment for ADHD is very clear in the literature. We know that medication is incredibly helpful above and beyond therapy and behavioral modifications alone. As I mentioned before, it gets messy when someone also has an eating disorder as many ADHD medications are known to suppress appetite. But instead of concluding that medicating ADHD for someone who also has an eating disorder is contraindicated, we need to explore the nuances in this as well. 

While ADHD medication may compromise hunger cues, the medication may also help to overcome other barriers to recovery. For example, the client may be better able to strategize and execute on their meal plan as they suddenly have the brain capacity to do so. ADHD medication can relieve some of the symptoms that the eating disorder worked to mitigate, such as dysphoria, distress, feeling overstimulated and overwhelmed. Clients may be better able to tolerate the distress inherent in eating disorder recovery with the help of medications that can calm their minds. 

I am not “that kind of doctor” that can assert medication for clients. I am the kind of doctor who advocates for treating all the presenting concerns our clients face. And the more we understand about ADHD and its relationship to eating disorders, we understand the critical importance of treating both illnesses. If we only treat the eating disorder and neglect ADHD, our clients will likely struggle more on the path to recovery and in their ability to sustain it. Besides this, we would be neglecting ongoing and treatable pain that were treated, which would bring immense relief, increased confidence, self-awareness, and continued motivation. 

We have a lot more to learn and understand about ADHD and eating disorders. And what we do know so far, calls us in the field to look closely at the nuances these presentations bring to treatment, and how we need to be flexible, mindful, and deliberate in how we help treat our clients to optimize their success.